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Review
. 2019 Aug 17;19(1):155.
doi: 10.1186/s12871-019-0813-8.

Anesthetic management of a patient with limb-girdle muscular dystrophy 2B:CARE-compliant case report and literature review

X Q Cao  1 , K Joypaul  2 , F Cao  3 , L L Gui  1 , J T Hu  4 , W Mei  5
Affiliations
Review

Anesthetic management of a patient with limb-girdle muscular dystrophy 2B:CARE-compliant case report and literature review

X Q Cao et al. BMC Anesthesiol. .

Abstract

Background: Limb-girdle muscular dystrophies (LGMDs) belong to few neuromuscular disorders mainly involving pelvic and shoulder girdle muscles. Also, cardiac or pulmonary complications, increased rhabdomyolysis risk when exposed to volatile anesthetics and succinylcholine may increase anesthesia related risks. However, current reports about the anesthesia management of these patients are limited.

Case presentation: We described our anesthetic management of a 36 years old woman with LGMD 2B receiving arthroscopic knee surgery. In consideration of the high risk of rhabdomyolysis, total intravenous anesthesia (TIVA) was selected for her surgery. Considering the unpredictable respiratory depression, opioid based patient-controlled intravenous analgesia was replaced with an intra-articular cocktail therapy consisting of 20 ml of 0.2% ropivacaine. Also, we reviewed the literatures on anesthetic management of LGMD through searching PubMed, in order to provide a comprehensive and safe guidance for the surgery.

Conclusions: Carefully conducted general anesthesia with TIVA technique is a good choice for LGMD patients. Neuraxial anesthesia may be used if general anesthesia needs to be avoided. To warrant safe anesthesia for surgery, any decision must be well thought out during perioperative period.

Keywords: Anesthesia; Limb-girdle muscular dystrophy 2B; Surgery.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Left knee joint magnetic resonance imaging. It revealed left knee joint injury. a Osteoedema of distal femur; b Rupture of anterior cruciate ligament; c Relaxation of quadriceps femoris tendon and patellar ligament; d Posterolateral osteoedema of tibial plateau
Fig. 2
Fig. 2
photograph of patient’s lower limbs. It showed muscles of lower limbs atrophy slightly. Muscle strength of the lower limbs was at level 4, whereas muscle tension was decreased
See this image and copyright information in PMC

References

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